Cause of 13.2% deaths in India remains unknown

BENGALURU: Of all the registered deaths in India in 2014, the cause for 13.2% remain “unknown” and the symptoms are not diagnosable. This is the second-highest leading cause after diseases of the circulatory system, which indicates that a considerable part of the population has limited or no access to medical care.

An age-wise analysis shows that one of every 10 deaths is an infant aged less than a year, painting a grim picture of infant mortality. The latest report on Medical Certification on the Cause of Death (MCCD) has this and other related data.The findings are based on medical records of 10,66,221 deaths registered across the country during 2014, which is 20% of all deaths. Of these, 1.4 lakh (13.2%) are due to unknown causes. The 2015 figures are being compiled. According to MCCD, of the eight leading causes, ‘Symptom Signs & Abnormal Clinical Findings Nowhere Else Classified’ (undiagnosed or death due to unknown reasons) is second only to ‘Diseases of the Circulatory System’ which accounts for 3.37 lakh deaths (31.6%).

The third leading cause, accounting for 1.26 lakh deaths (11.9%), is ‘Infectious and Parasitic Diseases’, while ‘Diseases of the Respiratory System’ has taken 82,754 lives (7.8%).

While it’s no surprise that diseases of the circulatory system, which include coronary artery disease, atherosclerosis, arteriosclerosis, and arteriolosclerosis; stroke and heart failure among others top the list, experts say that not knowing the cause of death is a poor indicator.

Hosmat Hospital medical director Dr Ajit Benedict Ryan said: “Generally, doctors can diagnose the cause of death of most patients whose medical history is known. However, if the cause of is unknown, it’s because they have not been treated by a doctor.”

“Even postmortems cannot give the actual cause when results point to multiple symptoms,” he added.

‘Certain Conditions Originating in Perinatal Period’ is the fifth leading cause group taking 77,182 lives. The report says this is the highest cause so far as infant deaths are concerned.

Too many infants

The age-wise classification points to the need for strengthening the network of medical care, with 1.06 lakh or 10% of all deaths registered being that of infants under one year.

In fact, several international agencies and organisations have made similar observations and recommended action on a war footing.

A Lancet report released in May, for example, said India was worse than other Asian countries like Pakistan and Bangladesh and African countries like Ethiopia, Tanzania, Nigeria, Congo and Niger in the top ten countries, when it comes to neonatal deaths.

Dr Asha Benakappa, director, Indira Gandhi Institute of Child Health, had told TOI earlier there is an urgent need to “strengthen the system if we are going to move to institutional deliveries. There needs to be more people who are trained and are available.”

Another senior doctor, on spoke on condition of anonymity, said the number of professionals being trained in performing deliveries at home is reducing and the traditional midwife is vanishing. “While it is okay to want more institutional deliveries, we must also ensure the system is equipped to deal with it,” he said.

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